Bipolarity in eating disorder: comparison of hcl-32 and bipolarity index

  • MD Rodolfo Campos, Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, School of Medicine of the University of São Paulo, Brazil
  • PSC Rogéria Taragano, University of Sao Paulo, Brazil
  • MD Sabrina Campos, 2- Eating Disorders Unit (AMBULIM) - Department and Institute of Psychiatry, Clinical Hospital, University of Sao Paulo, School, Brazil
  • MD PhD Táki Cordás, 2- Eating Disorders Unit (AMBULIM) - Department and Institute of Psychiatry, Clinical Hospital, University of Sao Paulo, School, Brazil
  • MD Jules Angst, Zurich University Psychiatric Hospital, Zurich, Switzerland, Switzerland
  • MD PhD Ricardo Moreno, University of Sao Paulo, Brazil

Objectives
Diagnosing Bipolar Disorder (BD) is a challenge due to its phenomenological complexity, variable course and correlates. HCL-32 is a screening instrument for hypomania developed to be more sensitive in the detection of hidden bipolarity; it focuses on both overactivity and changes in mood. The Bipolarity Index represents an effort to combine clinical dimensions in order to evaluate mood disorders; it is currently designed to determine to what extent someone is bipolar. We aimed to describe the correlation of these instruments in Eating Disorder (ED) patients.

Methods
39 female SCID-P DSM-IV ED patients aged 18 to 45 years were evaluated and were also examined with the HCL-32 and Bipolarity Index on the same evaluation. Binge-Eating Disorder patients were excluded.

Results
A positive association was found comparing the total score on the HCL-32 and the Bipolarity Index evaluated by Spearman's correlation (coefficient 0,578) (p, 0,001). Using the Mann-Whitney Test, we compared Bipolarity Index scores in the group scoring over 18 on the HCL-32 (cut-off in the Brazilian sample) with the group who scored under 18 and found they were significantly different (p< 0,001). Mean in the HCL-32 over 18 was 55, 06 (SD= 19, 44) and under 18 was 32, 48 (SD= 17, 57).

Conclusion
Instruments for the detection of manic/hypomanic symptoms have been increasingly used as screening for suspected cases and for milder forms of bipolarity. Dimensional approaches evaluating different clinical features in a high risk population (ED) showed strong correlation with the classical phenomenology assessment.